News

2 Marin County patients die after outbreak at care center

Contagious norovirus sickens dozens at Mill Valley facility

By NELS JOHNSON and PAUL LIBERATORE Marin Independent Journal

Posted:
01/05/2013 10:43:10 PM PST

Updated:
01/06/2013 04:37:32 PM PST

Two elderly patients died over the holidays and six others were taken to the hospital following an outbreak of contagious norovirus that since Dec. 24 sickened 59 people at The Redwoods senior residential care facility in Mill Valley.

Marin County Public Health Officer Dr. Matthew Willis reported Friday that the two died at The Redwoods after falling ill, and that while norovirus may have contributed, it cannot be regarded as the cause of death.

The county said Friday that the outbreak at The Redwoods appears to be in "waning stages."

Both patients were 86 or older, and both were "do not resuscitate" patients with "significant pre-existing conditions," the health officer added.

"This is a viral illness that causes dehydration and in patients in a tenuous condition to begin with, it may contribute to but cannot be called the cause of death per se," he said.

Dr. Willis commented following Independent Journal inquiries about reports of illness at the facility. A spokesman for The Redwoods was not available for comment on the situation.

Since the outbreak, residents have been under what they describe as a quarantine that has been extended until next Wednesday. Under its restrictions, all group activities and meetings have been canceled and the communal dining room has been closed. Residents are having to take their meals in their rooms, and some of them are not happy about it.

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"I'm furious about the way it's being handled here," said resident Rachelle Marshall, 85. "The meals are cold, late, inadequate, meager. We never know from day to day what the situation is. This has happened before, and I can't help but think that more planning should have been done. The people who work here are wonderful, but the kitchen staff should have planned for this."

She said she and her husband were ill for a day and a half with what she believes was the norovirus.

"It's what we used to call the intestinal flu," she said. "It's awful, but it goes away."

Despite the quarantine, Marshall and other residents in the Redwoods' Seniors for Peace Group were out on the sidewalk in front of the facility with their signs and their songs, protesting war.

"We're not supposed to be out here because we're under quarantine," said 95-year-old Bill Usher, facilitator of the group. "But we've been doing this every Friday for 10 years and we don't want to miss a week."

Asked if he was worried about the outbreak, he said, "I'm not losing any sleep over it."

The gastrointestinal virus, which causes nausea, vomiting, diarrhea and stomach cramps, broke out at The Redwoods on Dec. 24, and has afflicted residents and staff members in all sectors of the multicare facility.

The Redwoods outbreak follows an outbreak at Villa Marin in San Rafael that sickened 27 people in November, as well as a wave of illness that hit 14 people who attended a business party in Mill Valley.

The flu-like illness typically lasts for anywhere from 24 to 48 hours.

"Norovirus ... can be serious, especially for the very young and very old," Dr. Willis said. "Although not common, death may occur, usually as a result of dehydration."

Linda Ferguson, the county's supervising public health nurse who also serves as "communicable disease controller," visited The Redwoods Friday and returned to report the illness appeared to be ebbing.

"We're seeing what we normally see with an outbreak," she said. "It appears to be in the waning stages."

County nurses have advised care facility staff on sanitary precautions, limiting visitation and related matters, she noted. "Our goal is to stop the spread of the norovirus as soon as possible," she said. "It's not a very pleasant disease."

Dr. Willis stressed that outbreaks of the illness can occur anywhere, but noted those in communal environments such as care facilities, schools and other group settings are especially vulnerable to the contagion.

Marin is no stranger to norovirus outbreaks.

The virus sickened more than 200 residents and 60 staff at seven Marin senior care facilities in 2009.

In April 2007, norovirus was suspected when 27 residents and staff members at a nursing-care facility in San Rafael became ill.

In January 2007, more than 850 inmates and nearly 50 staff at San Quentin State Prison became ill over several weeks in a norovirus outbreak. Outbreak resulted in a nearly three-week quarantine of the prison.

"Because there is no cure, we focus on prevention," the health officer said.

The most important thing to do is to frequently wash your hands — and always before eating, preparing and handling food. Those who are sick and their children should stay home. Contaminated surfaces should be cleaned with chlorine bleach of up to 25 tablespoons per gallon of water.

Dr. Willis, who holds a master's degree from Harvard and a medical degree from Temple University School of Medicine, was appointed county health officer last year after serving as epidemic intelligence officer at the Centers for Disease Control and Prevention in Atlanta.